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Healthcare.gov’s Users Speak Out: ‘Clean This Mess Up’

Health and Human Services asked for comments about its website. It got them by the hundreds. Consumers and insurance agents say they were stymied, and one applicant said he and his wife were wrongly listed as incarcerated — then denied.

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(Karen Bleier/AFP/Getty Images)

Over the weekend, the U.S. Department of Health and Human Services began unveiling its effort to fix Healthcare.gov, the home for the federal insurance marketplace. Part of that was a blog post soliciting comments from folks who have tried the site.

"Most importantly, we want to hear from you, and make sure that your experience with HealthCare.gov is a positive one.  If you have any comments, either complimentary or critical, please let us know by sharing your feedback at https://www.healthcare.gov/connect/.  We've already heard so many stories of individuals getting health insurance for the first time, and we are dedicated to making that possible for all Americans."

The Obama administration has not always been transparent about Healthcare.gov: A case in point is how HHS has withheld the number of people who have been able to successfully enroll. But in this instance, the administration allowed comments to the blog post to be seen by all (after moderating them and removing identifying information). Commenters’ identities were not verified and they are identified by whatever name they entered.

As of yesterday afternoon, we counted more than 500 comments. My colleague Mike Tigas pulled them from the site, and I’ve been analyzing the feedback.

“Repeal Obamacare,” several commenters wrote, making political statements based on the website’s problems.

Some urged patience: “Turn off the TV and stop listening to the naysayers,” Darlene wrote. “Its [sic] better to wait patiently and get great health care than to get emotional and frustrated and wind up with NO healthcare...”

Others, like Kim, offered to help: “I have a home office and am VERY tech savvy. I would like to be able to help in whatever way I can.”

By and large, however, the feedback has been negative. While some comments root for the site’s failure, many are from people who’ve tried to use the site without success. Some pose specific questions; others voice general frustrations. Because their identities and contact information isn’t listed (for understandable reasons), there was no way to verify their stories.

The problems touch people from all over the country. The posts below have been trimmed for length, but the original grammar and spelling are used (even if they contain errors).

Wrongly Listed As Jailed

“Website said my wife and I were ineligible due to current incarceration. We have never been arrested in our lives, both 63!!!!!!!!!!!!!!!!!!!!!!!,” Fred wrote on Oct. 21.

Health Problems Made Worse

“I have a pre-existing condition .... a-fib.....and actually had an attack after getting frustrated with this confusing mess,” Bill wrote on Oct. 22. (A-fib refers to atrial fibrillation, an abnormal heartbeat.)

Daughter is Not a Daughter Anymore

“I am having difficulty with my account,” Joanna wrote on Oct. 22. “It appears that my daughter was added twice so that I now have two daughters with the same name and social security number. I am unable to delete one of them.  Also, the drop down menu that relates to what relationship someone is to another is faulty. I choose that my husband is the father of our daughter and that my daughter is a dependant [sic] to me and my husband. What it actually shows though is that my daughter is a stepdaughter to her father and that my daughter is now both my husband and I's parent. “

Compromised Identity

“I can sign in ... but cannot see the plans available to me — they claim my identity has been compromised. So frustrating!” Rhonda wrote on Oct. 22.

Going in Circles

“I have been trying to get into the system since the beginning,” Marion wrote on Oct. 22. “I have created 3 different accounts and am not able to log into any of them. When I request the user ID or to reset the password it throws me back to the log in page where I can't login because it says I don't have an account. When I try to reset the password with the email I used it, I never get an email to validate my account. I won't let me create another account telling me I already have an account. I feel like I keep going around in circles. Will I ever be able to set up an account? “

Groundhog Day

“I've now filled out that same application multiple times and even though there are hitches and glitches, I do manage to get to the point where I should be able to shop,” wrote one person whose name is listed as “likebillmurrayingroundhogday, on Oct. 21. “However, once at that point, there is no place for me to shop! The system just kicks me back to starting the application again. It's like "Groundhog Day."

Blocked

“After many attempts I did manage to set up an account with a log in and password,” Francine wrote on Oct. 23. “NOW when I'm about to get to the meat and potatoes and go shopping a red box pops up and says "you can only do one application per state". WTF? Several times I was able to find a page that asked me if I was a Florida resident with a yes and no button and it appears that after the site drops off my computer it moves this from yes to no. I can no longer find this page, so this site has BLOCKED me.”

Circular Security Questions

“I get an error message after I answer the security questions that say the answers can't be the same, but they aren't the same. If people are getting past this error message, I would like to know how,” Samara wrote on Oct. 20.

Name Not Unique

“I've been trying to create an account since program inception (October 1).  I continually get a variety of crazy messages, the most recent being that I could not create an account because my first name, last name and email address are not unique!” Tom wrote on Oct. 20. “What the devil does that mean?  Most people use their names in their email address, so it's never going to be "unique."  I need health insurance for my 61-year-old wife and the Marketplace appears promising.  Clean this mess up!”

Insurance Agents Stymied

“I am insurance agent also President of Insurance Agency (50+ Insurance Agents plus 30 employees),” John wrote on Oct. 21. “We have 1000's of customers who want to sign up for health insurance and most will be subsidized. We have tried everyday since 10-1-2013. Maybe 2 applications have been processed. I have spent well over 250K getting ready for the ACA roll-out. My agency has been writing individual and small group insurance for over 25 years. We have marketed the uninsured and lower income. We have held events to get pre-enrollment applications. We just want to help people get the insurance they need.  What can you do to help me?”

Application Counselor Frustrated

“I am employed as a Certified Application Counselor in Scranton, Pennsylvania and I have not been able to successfully assist the approximately 50 people that visited me looking for assistance,” Suzanne wrote on Oct. 21. “I created an account for myself prior to October 1st to walk myself through the system and have not been able to successfully log in since October 1st.  Needless to say, I am as frustrated as the consumers who visited me are.  I hope the log in situation is fixed soon.”

ProPublica fellow Mike Tigas contributed to this report.

To brush up on today's congressional hearings, see Charles Ornstein's quick guide.

Daryl Northrop

Oct. 24, 2013, 2:57 p.m.

Why is anyone surprised? I’ve been through multiple IT rollouts/upgrades/new systems being introduced in the private sector, and it’s ALWAYS an absolute disaster.

The systems never work as promised. The end-users are never consulted with what features they actually need or want. And it always costs an enormous amount of money to fix the problems that apparently no one saw coming.

The same contractors that work for private companies designed this system for the government, and guess what, its a disaster.

The IT contractors that sell their services to private industry and to the government are responsible for this mess, not the heathcare reform laws.

Please note that these contractors were selected in 2007 by Bush administration.

The response to the so called “glitches” has been totally off base.  It should have been and still should be that the massive enthusiasm for the program has caused the backups.  Have you never stayed on line for almost any call to a busy corporation or government agency only to be told robotically “All lines are busy so we can help other customers; please wait and your call be answered in order…..”
Fact is the White House and HSS should have been smarter in how they responded to both the GOP campaign and ordinary media queries.

Bruce J Fernandes

Oct. 24, 2013, 3:39 p.m.

I have also been through multiple IT installations and upgrades of accounting and financial reporting systems.  Did anyone think that perhaps hiring and Oracle or SAP to integrate these complex systems might have reached a slightly better outcome?

Actually, the Obama administration couldn’t hire real wall street companies that earn big profits…. might PO his liberal base….. the idea that someone is making a profit on anything in this society.

I do believe an Oracle or SAP would have been better choices because these companies are used to the issues surrounding the integration of their main enterprise software with outside vendor components a customer finds irreplaceable and are unwilling to entrust a re-write to Oracle or SAP.

Anyone who has done what people like me have done are stunned at what we are now hearing constituted testing and rollout.  You NEVER try to do 100% rollout….. anyone involved at HHS hear the term “beta site testing”.... no, probably not inasmuch as you can count on 1 or 2 fingers the number of Obama administration officials that have actual private sector experience working for dare I say…... profit-making private sector companies… or is that a mortal sin within the Obama inner circle and entire administration for that matter?

Wilson Dizard

Oct. 24, 2013, 3:52 p.m.

This very biased story vaporizes my respect for ProPublica’s editorial probity.

More than 470,000 people have accessed the various web sites that provide information and enrollment for the new health insurance marketplaces.

Problems with those sites have resulted largely from the unprecedented decisions by many Repubilcan-dominated state governments to foil rollout of the Affordable Care Act in any way possible.

The federal health insurance marketplace system, for example, relies on data it has to pull from state-run health records systems. Those state databases introduce many problems.

State agencies in Florida and Georgia, controlled by Republican appointees, have pledged to foil plans to train “navigator” personnel to assist members of the public who are on the far side of the digital divide.

The last time the federal government attempted a health care reform of comparable scale and breadth was 1965, when it introduced the Medicare system.

The poorly disguised glee of GOP partisans at every report of a problem with the ACA computer systems, and their disingenuous attempts to conflate the notions of computer glitches with program failures, shines out from this article. Counterbalancing facts aren’t fairly presented.

It took Medicare two to three years to work out its initial problems.

As the writer of this column is in a position to know,  his own home state’s online enrollment system, “Covered Cal,” has supported more than 2.2 million separate visits by Golden State residents since it opened for business.

The pathetic rearguard actions of the radical reactionaries intent on defaming our Commander-in-Chief and all his works, while they themselves stand silent amid the racial taunts yelled by their less-educated political allies, points to the despicable source of their hatred for President Obama.

Fewer and fewer Americans are fooled anymore by the brazen lies that the extremist right-wing Republicans bleat in unison, which are yelped even louder by the bloviators in reactionary echo chamber like yourself, Mr. Orenstein.

Your clumsy attempts to mislead the public would be laughable, if they weren’t so sad and cynical.

Sincerely,

Wilson P. Dizard III

Bruce J Fernandes

Oct. 24, 2013, 4:15 p.m.

Mr. Dizard,

Millions should have been able to go thru the website by now if there had been allowance made for the idea that you do not register every user of a website.

One has to wonder why a website would ever be structured to collect personal and intimate information before you decide whether or not to purchase a product on that website.  I suppose government arrogance explains that; no private sector company would structure their website in that manner.  Who is the government to presume that 100% of internet users would buy the government insurance?

I wanted to do some comparison shopping for my step-daughter who will have to buy her own insurance.  That is not possible. 

You are clearly from the city of Denial.  They screwed up and now the screw-ups will mount because the problems are much greater than being reported right now and Obama et-al will find out how long they can play the game of salami slicing before they have to finally admit the fixes will take months; not weeks, and certainly not days.

um, the bush admin didn’t have anything to do with ACA so, yeah, no…they didn’t select the contractors.

Bruce J Fernandes

Oct. 24, 2013, 4:44 p.m.

Well Obama and his minions are blaming the states that refused to set up their own alliances…... meaning republican governors and anyone else they can assess blame upon in order to excuse their own gross mismanagement and bad judgment.

Now, they are trying to go back to the set up for Medicare in 1965 saying there were all sorts of problems.  The media lapdogs are going to finally reach a point where they will no longer give Obama cover.  My best guess is if republicans retain house and lose senate the loud splashing sound we will hear is the liberal media jumping ship; recognizing they better start tearing down the Obama administration in a last gasp effort to pretend they are responsible members of the 4th estate in America.

Sue Mccormack

Oct. 24, 2013, 6:44 p.m.

It seems that the problem is with the federal web-site.  There is also an issue with intense use in the first few weeks.  I am lucky to live in California with its Covered California program.  In order to have coverage by Jan. 1 I understood that we needed to sign-up by Nov. 15.  So I was just patient.  On Tuesday afternoon around 2 PM I got an account and by 2:30 PM I was signed up after comparing several policies.  The web-site was not perfect but it didn’t crash or anything.  The price is high but I am over 60 with some pre-existing conditions.  Since my Cal-COBRA lapsed 18 months ago I received quotes with a number of exclusions that were over $1,100 per month.  I would think that the the operators of the federal site, given that certain states have opted out of running their own programs, would benefit from talking with those states that have had more success.

The primary contractors are pulling a fast one…utilizing the technical ignorance of those who prefer to remain ignorant (and keep the American people ignorant) because that ignorance enables an attack on the ACA.

In Congressional hearings, the primary contractors are saying their bits worked, and all of the problems are the fact that the system wasn’t tested end to end.  Pro-Republican, anti-American people media sources (like, in a bizarrely un-Cronkite reversal, The CBS Evening News) are increasing the impact of those CYA attempts by selectively quoting the hearings.

But the fact of the matter is that anybody that knows anything about crafting software - from large to small efforts - knows that proper unit testing will ensure that all of the bits work together.  What is “unit testing”?  To quote Wikipedia (because in this case their article is accurate):

In computer programming, unit testing is a method by which individual units of source code, sets of one or more computer program modules together with associated control data, usage procedures, and operating procedures are tested to determine if they are fit for use.[1] Intuitively, one can view a unit as the smallest testable part of an application. In procedural programming, a unit could be an entire module, but is more commonly an individual function or procedure. In object-oriented programming, a unit is often an entire interface, such as a class, but could be an individual method. [2] Unit tests are created by programmers or occasionally by white box testers during the development process.

In general, you pound the individual bits with the inputs they will receive and monitor the output to ensure that you get the anticipated output.  It is no different from the way an automobile is built and tested…do you think automobiles would be safe if the engines, transmissions, brakes, steering, electronics, and so on had to be assembled into a complete unit - a car - before the functionality of the individual bits could be determined?

No..

Some individual bit of the Healthcare.gov website is a piece of crap; given that it failed under a test load of only 200 users, it is a significant bit (likely involving database inserts and updates or database selects/retrievals).

Yet the primary contractors are saying “Not my fault…”...and the Republicans are willing to accept their lame excuses - their $294 million worth of CYA - that because it enables the Republicans to attack both the ACA and so threaten the growing number of Americans for whom the ACA represents life itself.

And the media - Fox, of course, but to include such as CBS - are enabling the attacks with their own unique caricatures of “journalism”. 

(I give CBS credit where credit is due:  They are avoiding direct distortions in favor of selective editing, and then multiplying the effectiveness of their propaganda - their opening of an additional front in the right’s war upon democracy and the representatives of the American people - by immediately following ACA stories with such as carefully crafted “revelations” of “previously unknown” details of Benghazi.

Somebody figured out that those older Americans who don’t watch Fox watch the aged - and so presumably more trustworthy - faces of The CBS Evening News.)

I notice that I insert/leave extraneous words in my comments when I’m enraged by media aiding and abetting the right’s effort to link quality and length of life to wealth possessed.

Failure of the web site HealthCare.gov is not the fault of the President, it is the sole reposonsibility of the private co.‘s resposibile to build the web site.

Bruce J Fernandes

Oct. 28, 2013, 1:55 p.m.

NO!  This is 100% the government’s fault IF the following, simple assertion made by the lead contractor during his congressional testimony turns out to be the truth.

He stated the government’s insistence on the website requiring immediate registration without the ability for browsers to come in and get pricing information created a new level of complexity and assured overloading the website with registrations instead of people who simply wanted to get pricing information.  Complexity…. I doubt that part of the statement but overloading the website because everyone is locked into a registration process that requires fact checking…. forget the politics and just concede that was wrongheaded design.

That statement is a matter of record and anyone who has done any systems work knows that you do not construct a website demanding immediate registration.  We can all speculate why the government wanted the website set up that way. 

I was able to go several insurance company websites and quickly get health insurance premium pricing and co-pay/deductible information and determine if my most treasured medical providers were in their plan as providers.  I was doing this in the immediate period while the federal website was failing.  I was able to get on the phone and ask my 2-3 questions I needed answers to and then they asked to go back to the website to complete registration which I did in a matter of five minutes because this is private sector ACA-approved. 

I am eligible for subsidies but I was raised better than that having been taught that anything you accept from government comes at a greater price down the road.  Something that stayed with me all my life is how close I came to being bused to an intercity school because my rather poor school district had taken some unrelated federal funds and had inadvertently and unknowingly agreed to concede to busing kids cross town in return for the funds.  I lived about 1,000 feet from my grade school and my mom and a lot of other moms raised holy you know what and stopped the plan in its tracks.

It stays with you that someone in government for some reason believes they know more and that busing a kid who lives 1,000 feet from his local school to a school cross-town that takes 45 minutes to get to because of no direct access and frequent stops knows what is best for your child.

To that end I am convinced a few years from now ACA thru state exchanges will start taking a form more like Medicaid…. fewer and fewer providers staying in as the reimbursement rates fall far enough below the ACA approved private sector rates.  Yes, that means paying more for insurance outside the exchanges but we will start to hear stories about people in exchanges not having access to better care or superior care and then the dems will go off on how unfair it all is that rich people can buy their own individual policies and unfair that is and that we must equalize everyone’s outcome by going single-payer.

@Bruce J. Fox:

re:  and get pricing information created a new level of complexity and assured overloading the website with registrations

I emphasized the lie in bold</i> print.

The reader might be interested in

http://www.usatoday.com/story/news/politics/2013/10/23/house-hhs-hearing-health-care/3170177/

from which I quote

Cheryl Campbell, senior vice president of CGI Federal [the “lead contractor”], said in advance testimony for her scheduled Thursday appearance before the House Energy and Commerce Committee that <b>another contractor was responsible for the technology that allowed users to create new accounts and which caused the initial bottleneck issues on the site.

Still, Campbell said, CGI is responsible for some of the problems, too.

“Now, as more and more users have been able to proceed to the (exchange) over the past several days, more individuals have enrolled in qualified insurance plans,” Campbell’s prepared testimony says. “However, the increased number of transactions in the (exchange) have caused system performance issues (such as slow response times or data assurance issues) that now need to be addressed through tuning, optimization, and application improvements.”

Paul Harvey-ing it, there.

Blaming the government may fit your political narrative, but playing games with the truth just makes you look like another untrustworthy member of “the right”.

I also prefer comments that don’t give an anonymous “lead contractor” as the source…I’d note the quote I use is likely the a/the boss of the “lead contractor” selectively quoted by Bruce.

lollll…add disgust to anger among the emotions that cause me to fail to provide sufficient proofreading before I post.

Bruce J Fernandes

Oct. 28, 2013, 5:12 p.m.

I blame the government because only the government would have the arrogance to demand that full registration was required before you could obtain pricing…. what private sector company having to compete in the private market would ever think for a moment they could be so arrogant as to demand registration whether or not you actually use the website to purchase health insurance?

The lead contractor’s rep appeared as part of the congressional testimony…. it is a matter of record and I simply site it because it is stunning to think that these companies would have ever concocted such a stupid approach to website design.

In time, those contractors will release the details of the spec demanded by the government and all the changes along the way and then we will get the full truth.  For now, all we can do is site testimony given by these contractors last week which will surely represent more honesty than we can expect to get from the administration’s gang that never shoots straight.

Daryl’s absolutely right, here.

The difference between a roll-out on government contract and a roll-out on private contract is that the private industry pushes the deadline back when things run late.  Governments have legally-mandated deadlines.

The same goes for manufacturing, too, by the way.  Except for cars, which are incremental annual changes, just about every product you own ran late and would have been a disaster if someone said “ship it anyway, we made promises.”

There is one thing that should be investigated, though, that occurred to me when I looked at the site:

How did this full-registration system get through the Paperwork Reduction Act of 1980?  Based on that law, any agency collecting information from the public needs to describe the specific objective in acquiring that information and the plan for using that information.  The forms are also required to explain that purpose and plan, an estimate of how long it takes to fill the form out, and whether responses are voluntary.

It’s a pretty stupid and archaic law in many respects, of course, and was even back when it was passed.  Today, it’s why organizations are reluctant to listen to you Tweet at them—they don’t have a plan to use that information.  But regardless, the site still appears to violate pretty much every aspect of the law, which strikes me as a bad start.

On the other hand, this is the same Congress that believes in the Debt Ceiling (a law about the maximum number of war bonds, which shouldn’t extend to override the Fourteenth Amendment stating that repayment of our debts isn’t on the table), supports surveillance, and really and truly believes they need Boehner to be allowed vote on or even debate bills.  So maybe they didn’t notice that, either.

@Bruce J Fox who wrote


I blame the government because only the government would have the arrogance to demand that full registration was required before you could obtain pricing….

Special circumstances…you see we have these nominal Americans who want to deny health care to poor Americans so very, very bad that they are not above attempting to crash the website with manual and even automated bogus queries.

Unless, that is, you make them accountable first by associating their names to what they do.

I registered on-line for the Affordable Healthcare, then I verified by info, but it was denied. I called the verification company who informed me that they required my Soc Sec Info. I told them the Government Application Form stated it was optional. I went on to tell her that I was not comfortable putting my SSI in cyberspace to a verification company or anyone else. She then said then , it is required and don’t know why Govt is stating it is optional and she cannot process my application to sign up for Affordable Healthcare. This is a problem, if the government site says this is not required. Who wants to put their info out there if the website already has plenty of technical issues???

Bruce J Fernandes

Oct. 31, 2013, 10:25 a.m.

Ibsteve,

Your arrogance is noted.  This isn’t about denying healthcare for poor Americans.  That could have been addressed with Medicaid expansion because poor people and working poor can be given HIGHLY subsidized insurance but that does not mean they will suddenly have that $30 copay for the doctor visit and maybe chest congestion requires a $35 xray and then another $30 for a med.

There was case study done where they took a single woman with two children earning $30K/year.  Determined her subsidized health insurance would be limited to a cost of $900/year.  She paid zero previously which we all agree is not good:

Questions:

1. Where does she find $900 if she is spending everything already?
2. Will she take herself or child to a doctor assuming bronze care and be able to pay $30 point of service minimum and maybe up to $95 to include and/or xray and/or med?

Keep you eye on the copay and deductible issues which are being entirely ignored by the media at this point in time.  When all these newbies to health insurance start to understand what those of us began to understand years ago….. that healthcare isn’t going to be free or near free….. you will have a new problem.

I can already see in light of Obama’s trashing of insurance companies in his Boston speech yesterday where this is all going.  We will have someone die who had insurance but didn’t have the money for point of service copays.  Then the democrats in congress will say its unfair to have copays and deductibles for people and everything should be at such a low copay and deductible insurance wouldn’t be affordable for any of us THEREFORE its time to go to single payer.

I believe history will show a massive expansion of Medicaid for the working poor raising the income levels would have done far more for people than letting them believe they had affordable health insurance where the definition of affordable is based on a heavy government subsidy.

When we get to the copays and deductibles issues then we will see a firestorm of anger from people.

I saw it the other day and Obamacare has not started.  A woman who just got insurance to cover to 1/1/14 went to a WalMart walk in facility operated by SMA here in Nevada.  When the receptionist asked for the $30 copay she flipped out.  She thought it was free.  We are a deeply troubled society when anyone thinks anything is free.  I hate the word free and in truth the various well health initiatives in Obamacare should be termed “no charge services”.  Using the word free treats everyone like they are too stupid to understand that someone, somewhere is helping to subsidize these no charge services.

The next thing to watch is CBO next year when their update will show ObamaCare has no savings and will cost taxpayers which of course was not the intention.  Reality will bite hard and my greatest hope is premiums are raised to reflect an attempt to actually maintain something called an actuarial balance in this program inasmuch as the battle to better actuarially balance social security and medicare is all but lost during the remainder of Obama’s presidency….

Not because of Obama.  I think this is something he gets but Pelosi and Reid are behind the curtain say no changes to those programs.

lolll…you’ve noted my arrogance? 

When you’re so sure that the American people and all of the rest of ProPublica’s global readership is so stupid that you believe that you can pass off expanding Medicaid as the proper solution to the increasing number of Americans without decent or any health care?

Ever consider the possibility that the readers you have such intellectual disdain for will do a web search for the words “republican governors refuse to expand medicaid”????  Or review the Republican reaction to “single payer” proposals in the Congressional Record?

The next thing to watch is CBO next year when their update will show ObamaCare has no savings

And to top it all off, you project a hypothesis as an inescapable reality (on the bright side, propaganda that ignores the time dimension the rest of the universe is bound to is unusual, at least).

Which is not to rule out the possibility that members of the right - especially those who are being enriched by the current system of denying those who need health care health care insurance - will work to make your hypothesis a reality.

One could interpret your willingness to make that projection as evidence of precisely that, in fact.

Speaking of my greatest hope is premiums are raised to reflect an attempt to actually maintain something called an actuarial balance...

I wonder if anyone here is an actuary?  Now there is one field - because of the approaching illegality/futility/obsolescence of insurance corporation <strike>death panels</strike> decision-making processes that are designed to ensure that any insured who might incur payouts are dropped - that may suffer an employment hit.

Bruce J Fernandes

Nov. 1, 2013, 12:20 a.m.

Steve,

You believe in redistributing health wealth from the middle class to the poor expecting the middle class to not only pay for the redistribution but to also settle for less in the new system.

Republican governors fear the rug will be pulled out from under them after the first three years promised federal revenue sharing.  In Nevada, our republican governor ran the numbers and felt it could work here because we have a different situation than other states.

If you took the time to listen to each republican governor you would find out they did not go 100% political and made their case of the fear of loss of federal share later on and nothing was done at the federal level to give any assurances their fears would not in fact be realized.

Kasich in Ohio has similar characteristics to NV and has signed on.  Some states led by democratic governors are taking the risk and we will all see what happens in 2-3 years.

If the federal budget gets blown and the sequester is still in place there will be no methodology allowing for continued Medicaid funding to the states and those governors that rejected increasing the Medicaid rolls may look like they made a wise budgetary decision on behalf of their state.

Getting back to the redistribution of health wealth from the middle class to the poor.

I am not rich but I have the exact healthcare I want to have and I am getting it through an insurance company that refused to participate in the state alliance.  Why did they refuse?  Because the law is written requiring insurance companies that offer ACA compliant plans inside and outside the alliance must use one universal community rating to determine future years’ rates.  That would mean people in ACA compliant plans outside the state alliance would have to share in the cost of alliance members who are paying less for lesser plans and in many instances also getting tax subsidies.

My insurance company consciously decided that would be unfair to people like me willing to pay more for insurance that gives us virtual full freedom to pursue our medical needs without gate keepers and having to subsidize participants in state alliance plans who will pay less for lesser care and get subsidies.

If you don’t get what I am saying it is the beginnings of the two tier healthcare system I have been writing about where people who settle for the state alliance plans pay less, get tax subsidies, but will see the insurance quality slowly erode.

Today, many people learned for the first time many…. most in fact alliance plans will pay ZERO for out of network medical care.

I had a surgery in FEB and the anesthesiologist was outside my network.  My plan paid his fee and I didn’t have to pay anything more because my surgery resulted in payment in full of my deductible in one fell swoop.  The bill from the anesthesiologist was full value over $3,000.

People in the alliance plans had best take care to confirm every member of a surgical team is in the state alliance but some doctors will only work with their hand-picked anesthesiologist and no one else regardless of their network or out-of-network status.

Steve you can pretend to think like most liberals that decency prevails as it relates to ObamaCare.  I submit over the next many days we will hear about more and more injustices by many Americans and the anger level will rise and Obama is destined to have his popularity numbers drift into the 30s.

Steve, no one has gotten to see the alliance plans.  Many, most require 100% payment of deductibles up front.  Plans outside the alliance never have and never will demand such a requirement.

When the American people see there will be two classes in insured my guess is over time a great many people will abandon the state alliances if they can afford to do so as they begin to see the winds of change that turn state alliance health insurance into glorified Medicaid.

You go ahead and settle for what Obama and Sebilius give to you.  People like me have lived our lives looking to government for nothing and I do believe it would be better to expand Medicaid to the masses who we will find out over the next few years do not have the financial capacity to pay co-pays and deductibles anyway.  So why give newbies who have never had health insurance something they will refuse to use once they see that free healthcare isn’t as free as they thought it would be?

re:  You believe in redistributing health wealth from the middle class to the poor

lolll…neat twist.

Health insurance of any kind is “redistributing health wealth”, you know…

In fact - because you admittedly used your health insurance

I had a surgery in FEB and the anesthesiologist was outside my network.  My plan paid his fee and I didn’t have to pay anything more because my surgery resulted in payment in full of my deductible in one fell swoop.  The bill from the anesthesiologist was full value over $3,000.

you are a beneficiary of wealth redistribution.  Now you’re worried somebody else’s life might be saved by the same kind of system - but at some small cost to you…

I think you failed the greed or humanity test.  A religious person might start sweating, now…

Bruce J Fernandes

Nov. 1, 2013, 10:38 a.m.

Steve,

From today’s Washington Post, hardly a beacon of conservative thought.

Eight out of ten early enrollees signing up for Obamacare are signing up for Medicaid.

Now before you go off on some socialist rant about evil businesses, republicans destroying the economy, and greedy people try as difficult as it might be to think outside the box

First, governors, all republican, because the party would have destroyed any democratic governor opting out of Medicaid expansion… made a decision and this early enrollment information was on their list of concerns.  If the federal government does not offer significant reimbursements for Medicaid after the statutory period under ACA states would have to raise taxes big time to fund the expanded Medicaid entitlement.

We all better hope those numbers change because the result to all of our insurance premiums will be huge.

There will soon be a report coming out showing a significant number of young people are signing up for Medicaid because their income is below the amount under ACA requiring purchase of an ACA plan.  Unfortunately, that is a function of the terrible times we live in.

I paid insurance premiums since I was 18 years old.  If I could have lived my life and never need medical care and just drop dead one day after a long life like my grandfather that would have been OK with me.  For you to suggest I am the beneficiary of redistribution of wealth in the context you make it is disgusting and shows how liberal and really ill-informed you are….. you are a no-information voter of that there is no doubt.

People do not buy insurance hoping they receive value in return for that insurance.  Insurance is preventative.  I have homeowners insurance since I was 21 and never had to file a claim against it… was I supposed to hope my house burned down or was damaged so that I could recover some or all of past premiums paid?

Steve you probably should stop writing if you are going to write gobbletgoop that shows just how truly ignorant liberals are about insurance and its purpose in our lives.  Large populations buy insurance to cover for a risk.  I paid $7,000 out of pocket last FEB for that surgery.  I paid my maximum deductible.  I wish I never needed the surgery and wish I didn’t have to pay that deductible.  But that insurance was there when I needed it.  If I didn’t need it I wouldn’t use it.

You have no shame when you suggest insurance is some wealth redistribution scheme based upon use of insurance.  The redistribution of health wealth is a function of asking the middle class to pay higher premiums in order to provide premium support to lower income people and my feeling is it would have been cheaper to expand Medicaid including income levels and for the federal government to provide LONG TERM assurances to the state regarding Medicaid funding levels rather than engage in this massive redistribution between middle class and poor.

You want to say Medicaid isn’t all that good?  Well its better than nothing and oh by the way if you don’t like your life circumstances we used to say in America take the bull by the horns and better your own circumstances rather than line up in a government line for handouts and giveaways that are clearly unsustainable and will only accomplish turning this nation into a bunch of government dependent takers who will vote democratic so they can keep taking.

@“Bruce J Fernandes”

Your…missive…is full of contradictions.

You say

Now before you go off on some socialist rant about evil businesses, republicans destroying the economy

and then you say

Unfortunately, that is a function of the terrible times we live in.

in acknowledgement of the fact that the Republicans have put a lickin’ upon our economy…upon our country.  Or is the reader supposed to “forget” the Republican defeats of mass transportation, conservation, and alternative energy measures since the 1973 OPEC oil embargo that have kept America addicted to oil - and so kept ever increasing foreign oil payments as a tax upon our economy as a whole, and ever increasing gasoline and fuel oil prices as a tax upon each and every consumer in America?  Thus driving America’s cost structure ever higher, and making American “labor” (“We, the People”!!!) ever less competitive on the global market?

Is the reader supposed to “forget” the Republican support of inequitable free trade, which thrust American “labor” (“We, the People”!!!) into competition with nations which rig their currency exchange rates with the dollar, thus guaranteeing themselves competitive primacy?  Costing America jobs and the tax base that supports our military - and the technology (and the means of manufacture of that technology) that enabled America to defend herself with the mere hint that we’d pop “Star Wars” out of our black bag?  More pertinent to this discussion, is the reader supposed to “forget” that the Republicans’ inequitable free trade cost America millions of good jobs that provided health care benefits, thus contributing to - if not creating - the “health care crisis” that necessitated the Affordable Care Act?

Is the reader supposed to “forget” the cost of the Republicans’ Afghanistan and Iraq Wars when they consider (in your words) “the terrible times we live in”?  Is the reader supposed to “forget” that the Republicans lied America in Iraq with tall tales of WMDs and al Qaida training camps?  Is the reader supposed to “forget” that the Republicans - to protect the tax cuts they gave the wealthy few who finance and so own them - sent too few, too under-armored into Iraq, thus transforming an invasion into an occupation…thus extending a war that the Republican Secretary of Defense promised would last only “Six days, six weeks…I doubt six months.” into nine years when the troops (far, far fewer than General Eric Shinseki requested before he was booted out of the way for doing his job and telling the truth) could not police up Saddam’s tons of explosives and artillery shells before they became the IEDs that left many an American watching their lives drain away into the sands of a foreign land?  Is the reader supposed to “forget” what the cost of those wars - and the cost of caring for the wounded of those wars - did to the national debt and our ability to maintain our infrastructure and the social programs that stand between our people and Republican greed…and death?

Heh…think I’ll leave this part of my reply before I get into the intricate subject of the Republicans, their deregulation, and their enabling of - their participation in - the mortgage-backed securities pyramid scam.

Suffice it to say the Republicans bear great responsibility for creating the health care crisis…and now they would watch Americans - the people and country they’re from and are tasked by the Constitution with serving - die to protect the rate of (more!) wealth accumulation of the few who own them.

(Continued next comment.)

@“Bruce J Fernandes” (continued)

You say

Steve you probably should stop writing if you are going to write gobbletgoop that shows just how truly ignorant liberals are about insurance and its purpose in our lives.

even as you say

The redistribution of health wealth is a function of asking the middle class to pay higher premiums in order to provide premium support to lower income people…

and have said

I had a surgery in FEB

and indicated that your insurance picked up the costs of your surgery, anaesthesia, and so on less deductibles - which you indicated were $7,000.00.  Given that you can’t get an ingrown toenail addressed for only $7,000.00 these days, the reader can look at that two ways:  Either your/your employer’s premium payments to your insurance provider come to a total sufficient to cover the cost of your insurance corporation’s disbursement (a case which, pre-‘Obamacare’, could result in the immediate termination of your policy as is still the case in other insurance areas like automobile insurance), or other people’s money - their premium payments - was used to pay for your health care…classic wealth redistribution.


In any event, the reader has to consider that the definition of “insurance” (to quote Investopedia) is

A contract (policy) in which an individual or entity receives financial protection or reimbursement against losses from an insurance company. The company pools clients’ risks to make payments more affordable for the insured.

Surely someone who tosses around phrases like “actuarial balance” knows that - beyond being the use of premiums paid by others to pay your medical expenses - the payout of indemnities is a demonstration of increased risk.  Now the question becomes one of whether the…actuaries…in your insurance corporation must or will analyze all of the rest of the individuals in your “pool” to determine whether they should raise premiums for everybody to maintain “actuarial balance” in light of the increased risk your need for surgery demonstrates.

Or, perhaps, just to recoup the cost of your surgery (with a little bit more for “profit”/the CEO, of course.)

Health insurance is identical to car insurance in that any increase in risk/payouts in a geographical area or among an age group will be used to justify premium increases for everybody in that risk pool.

Finally (and related), you say

You have no shame when you suggest insurance is some wealth redistribution scheme based upon use of insurance.

I say either that applies to you or your greed, selfishness, or sadism (just which depends upon whether you’re so eager to sacrifice the lives of America’s poor men and women…children and babies…because you don’t want to pay more/earn less, don’t want to be inconvenienced by an additional 15 minutes in your doctor’s waiting room, or like the idea of watching the poor suffer and die from a vantage point of safety) makes you willfully blind. 

Of course health insurance is a wealth redistribution scheme…all of capitalism is.  Health insurance, in particular, is designed to make the executives of insurance corporations and the shareholders of those corporations (with emphasis on major shareholders) a whole lot of money.

lolll…else health insurance corporations wouldn’t use actuaries/death panels…else there would have been little organized resistance to single-payer health care…else there would be no organized lobbying effort to permit insurance corporations to operate across state lines, enabling the mega-corporations to drive smaller competition out of business…there wouldn’t be any merger and acquisition activity to further threaten competition in the sector…

And certain key cogs in the Senate wouldn’t have been purchased.

This article is part of an ongoing investigation:
Obamacare and You

Obamacare and You

The Rollout of the Affordable Care Act has been marred by glitches and political opposition.

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